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Dumfries and Galloway Royal Infirmary

December 13, 2025December 14, 2025 / Harriet Richardson / 2 Comments

On a recent trip to Dumfries & Galloway, staying in a beautiful house on the coast at Rockcliffe, I called in at two former hospitals in Dumfries – both former iterations of the Royal Infirmary. This is a hospital with a long history that has taken it to four separate sites.

*The former Dumfries & Galloway Royal Infirmary, photographed November 2025 ©️ H. Blakeman*

The original Dumfries Infirmary was built to the west of Nith Bank, at High Dock, on land that bordered the river. The foundation stone was laid on 11 July 1777, and the infirmary received its first patients in 1778 – transferred from temporary premises. In 1807 the infirmary was granted a royal charter, and its benefactors incorporated as the Governors of the Dumfries and Galloway Royal Infirmary.

*Engraved view of the original Dumfries Infirmary, dated 1778, from John D. Comrie’s* History of Scottish Medicine to 1860, *London, 1927.* ref: M0009675: Wellcome Collection.

In the later 1860s the infirmary’s governors decided to relocate eastwards, to higher ground, and build a new hospital on a pavilion plan. This was the gold-standard in hospital design at the time, based on the principles of natural, cross-ventilation to minimise cross-infection. The governors held a competition for the design of the new hospital in 1868. A sum of £10,000 was proposed for the scheme, that was to include the architect’s fee and the salary of a clerk of works. The winning architect was John Starforth, whose practice was based in Edinburgh. Three years earlier Starforth had won the competition to design Greyfriars Church in Dumfries. He also went on to design the infirmary at Berwick-upon-Tweed, built in 1872-4, and Greenock’s poorhouse and parochial asylum (later Ravenscraig Hospital) built in 1876-9.

*Postcard of the former Royal Infirmary, probably* c.1900

The OS Town Plan of 1893 shows the basic layout of the new hospital. The western range comprised a central administration block flanked by ward wings. To the rear a central corridor led to two further ward pavilions. These two-storey pavilions contained wards on each floor on either side of the central spine corridor. At the farthest end of the wards, towers housed the lavatories.

*The Royal Infirmary on the OS Town Plan, surveyed in 1893 CC-BY (NLS)*

The foundation stone was laid on 16 September 1869. A report in The Builder in that year claimed that Starforth had amended the design to reduce the cost, but he refuted the accusation, stating that the lowest tender had been £8,650 9s 8d. (The highest was £10,875.) An architectural drawing of the infirmary was exhibited at the Royal Scottish Academy in 1870. The Builder jibbed at the skyline, which it thought unsatisfactory and commented that the design had ‘some degree of architectural pretension’.

North range of the Royal Infirmary, showing the ward pavilion on the north side of the administration block. *(Photographed November 2025 ©️ H. Blakeman*)

The building contractor for the infirmary was James Halliday, mason, and the contractor for the joiner work was John Mein. Mein also paid for the ‘cathedral glass’ in the central window above the main entrance. This was designed by James Ballantine of Edinburgh, in a geometric rather than figurative scheme. It featured pale shades of amber, green and blue in the upper section bordered by deeper shades of the same colours. The other main features of the entrance front were the statues of St Luke (the good physician) and Hygeia that flank the central window. These were executed by the local mason and sculptor, John Currie. Currie’s best-known works were ‘The Covenanter’ and ‘Old Mortality and his Pony’. He also carried out the figure of Dr Henry Duncan on the façade of the Dumfries Savings Bank.

*Central window above the entrance with figures of St Luke and Hygeia, November 2025 ©️ H. Blakeman*

Building work was largely completed towards the end of 1872, and an official opening of the infirmary took place in May 1873. Although the building was considerably larger than the old infirmary, it had the same number of beds (100). About a year after the new infirmary opened, an ice house was built on the site of the historic Christie’s Well, to the north of the infirmary. The door surround of the icehouse with two sculptured herms supporting a banner bearing the text ‘Christys Well’ was preserved and subsequently relocated to the new infirmary at Bankend Road. (There is a photograph of the door surround on the Art Uk website. The well is named Christie’s elsewhere, but was also known as St Queran’s Well.)

*The Jubilee Block and to the rear the King Edward VII block. Additions to the infirmary in the 1890s. Photograph ©️ H. Blakeman*

The icehouse was later replaced by the Jubilee Block, built in 1897 as a sanatorium for patients with tuberculosis. Another detached block was added in 1894 for infectious diseases. Both were built to designs by James Barbour. However, in 1910 the infirmary ceased to admit infectious diseases and subsequently both blocks were converted to staff quarters. The 1894 block was substantially rebuilt as a nurses’ hostel and became known as the King Edward VII Memorial block.

*Dumfries & Galloway Royal Infirmary on the 25-inch OS map revised in 1899, showing later additions CC-BY (NLS)*

During the Second World War two additional ward huts were built to the south of the main building as part of the Emergency Medical Scheme increasing its bed complement to 170. The war-time survey of hospitals conducted for the Department of Health for Scotland criticised the design of the wards, condemning them as no longer satisfying modern requirements for medical care. The hutted annexes were cramped, nearly all the specialist units were too small, and the out-patient department particularly congested. Rebuilding on a new site was recommended, the old infirmary might then be adapted for the chronic sick and infirm.

*The Royal Infirmary on the large-scale OS map surveyed in 1962 CC-BY (NLS)*

In 1948 the infirmary transferred to the NHS, coming under the Western Regional Hospital Board based in Glasgow. With limited funds, no action was taken in the early years of the NHS to rebuild the infirmary on a new site. Instead, some modernisation was carried out in the 1960s, including the addition of a day room for patients. Nevertheless, rebuilding was the long-term goal, enshrined in the Hospital Plan for Scotland published by the Department of Health for Scotland in 1962.

*Former Dumfries & Galloway Royal Infirmary, viewed from the north-west, photographed November 2025 ©️ H. Blakeman*

In the Hospital Plan, ten new district general hospitals were proposed at Inverness, Dumfries, Ayr, Kilmarnock, Coatbridge, Motherwell, Greenock, Paisley and Kirkcaldy, and in West Lothian. All but three of these were in the Western Region, and the new hospital for Dumfries was the first of those to be completed in 1974. In the late 1960s it was planned to adapt the former infirmary into a geriatric unit. The site for the new hospital was further out of Dumfries, fronting Bankend Road at the northern tip of the Crichton Royal Hospital site.

*The 1970s Dumfries District General, now Mountainhall Treatment Centre. Photographed in November 2025, ©️ H. Blakeman*

The foundation stone was laid on 16 September 1970 by the Chairman of the Board of Management for Dumfries and Galloway Hospitals, J. Wyllie Irving. The architects were the Glasgow-based Boswell, Mitchell and Johnson, and this was their first large-scale, health-care project. That said, it was the smallest of the new District Generals, with 424 in-patient beds. Frank Campbell, one of the partners in the firm, explained that the architects had aimed to design a building that was on a human scale, ‘integrated into the site and surroundings in a natural and unobtrusive manner’. They felt that a ‘massive multi-storey building’ would be oppressive. ‘It is an emotional experience going into a hospital. We attempted to create a less intimidating and more friendly atmosphere’. [quoted in Irving, Dumfries & Galloway Royal Infirmary…, p.97.]

*Mountainhall Treatment Centre (formerly Dumfries District General) photographed November 2025 ©️ H. Blakeman*

The hospital was designed on a linear plan, as then advocated by the Scottish Home and Health Department, taking the form of a four-storey, offset cross-shaped block. At the lower ground level were service areas, including staff dining and changing rooms, kitchen, stores and plant rooms. On the ground floor were the outpatients unit and the main diagnostic departments and treatment areas along with administrative offices. On the upper three floors were the ward units, comprising single and four-bedded rooms with views over the landscaped grounds, those on the west looking towards the Galloway hills. The landscaping of the site with trees, shrubs and flowers aimed to increase the sense of peace and spaciousness. Now the mature trees set off the east side of the infirmary, though some of the planting must have been lost to later additions.

*Mountainhall Treatment Centre, photographed through the trees from the east, November 2025 ©️ H. Blakeman*

The building contractors for the new infirmary were Melville, Dundas and Whitson of Glasgow. As with many of the large-scale NHS building projects of this period works were impacted by the economic crisis and industrial action, but nevertheless were not seriously delayed. The contractors handed over the new hospital in 1974. A period of ‘commissioning’ ensued, during which time the hospital was equipped and made ready for opening, including recruiting additional staff. Additional staff accommodation was provided in the form of eleven terraced houses for married staff, one for the matron, and flats for 126 other nursing staff. These are located to the south west of the main building. The official opening by Queen Elizabeth took place in 1975.

*Dumfries Dental Centre, one of the more recent additions to the site. Photographed in November 2025 ©️ H. Blakeman*

Various additions were made to the site, including the Cresswell Maternity Unit, a PFI scheme, built around 2002; a cancer care centre added in 2003, and a dental centre in 2008 (Davis Duncan, architects – now NORR). With the opening of the new Royal Infirmary, the 1970s hospital was refurbished as a day treatment centre (Ryder Architecture for NHS Dumfries and Galloway, Balfour Beatty Construction). The transfer of patients to the new Royal Infirmary at Cargenbridge from Bankend Road began in December 2017. Since then NHS Dumfries & Galloway has moved its headquarters and main admin offices to Mountainhall, following the closure and sale of Crichton Hall.

Sources: The Builder, 10 Jan. 1865, p.416; 14 Nov. 1868, p.839; 3 July 1869, p.521; 5 March 1870: Gordon Irving, Dumfries & Galloway Royal Infirmary – the first two hundred years, Dumfries, 1975, passim.: Dumfries & Galloway Standard, 3 Jan. 1872, p.7; 7 Feb 1872, p.7; 31 July 1872, p.5; 25 Dec 1872, p.5: Daily Record, 7 Dec. 2017, online: The Scotsman, 16 Oct 2019, online: For the new DGRI see the report on the BBC website here (retrieved Dec. 2025).

Obituary of John Starforth: Building News, 27 May 1898, p.741: Information on the local sculptor, John Currie, from William McDowall, History of the Burgh of Dumfries, Edinburgh 1867, p.864

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Orkney Revisited

July 6, 2025July 6, 2025 / Harriet Richardson / 1 Comment

I first visited the Orkney islands in 1989 when I was working on a survey of Scottish hospitals. I had not been back until June this year. This post provides a short account of the surviving historic hospital buildings in Kirkwall and how the hospital service has developed since the first general hospital opened there 200 years ago.

*The new Balfour Hospital, seen as you drive into Kirkwall from the south, photographed in June 2025 ©️ H. Blakeman*

As far as the hospitals on Orkney are concerned, the biggest change since the 1980s has been the opening of a new Balfour Hospital on the outskirts of Kirkwall for NHS Orkney. It was built in 2015-19 and officially opened in May 2021. The architects were Keppie Design.

*Views of the main entrance hub of the new Balfour Hospital, photograph ©️ H. Blakeman*

The new Balfour is the third iteration of the hospital which first opened in a converted house in Main Street, Kirkwall, in 1845. It was named after John Balfour, local landowner and former MP for Orkney and Shetland, much of whose fortune was derived from India as an official in the East India Company. In 1836, Balfour had appointed a board of trustees with instructions to use dividends from Mexican Government Bonds for ‘building, furnishing and endowing a hospital or infirmary with a dispensary … for the reception of such sick and wounded persons as may be recommended by those appointed by my said Trustees for that purpose.’ ¹

*The original Balfour Hospital on Main Street, Kirkwall, now the West End Hotel, photographed in June 2025 ©️ H. Blakeman*

The house in main street that was acquired for the hospital was built in 1824 by William Richan of Rapness, at least in part to satisfy the extravagant tastes of his wife, Esther. Richan had borrowed heavily, and put his affairs in the hands of trustees before his death in the Kirkwall house in 1830 after which it was sold to a merchant, James Shearer from whom it was purchased by Balfour’s trustees as a hospital. The house was listed in 1971 at Category B. The list description mentions an anecdote about Richan’s wife Esther, who was reputed to have won a wager that she could eat the most expensive breakfast by putting a £50 note inside a sandwich.²

*Kirkwall on the 25-inch OS map revised in 1900, showing the Balfour Hospital and Fever Hospital (towards the top right) and the Combination Poorhouse (bottom left), CC-BY (NLS)*

Originally the Balfour was called the ‘Orkney Hospital’. This was suggested by John Balfour, the founder, in preference to the proposed ‘Trenaby’s Orkney Infirmary’. The first resident matron was a Mrs Dearness, appointed in May 1845, and the first patient was admitted on 6 October that year on the recommendation of the surgeon, Peter Flett. In 1853 the name was changed to the Balfour Orkney Hospital, which was soon shortened to the familiar Balfour Hospital.

Fever Hospital built adjacent to the original Balfour Hospital in 1890-91, *photographed in June 2025 ©️ H. Blakeman*

Patients suffering from infectious diseases were admitted from the start, initially within the main building but in the 1870s one of the neighbouring houses was acquired and an additional nurse appointed specifically to care for the fever patients. Additional accommodation near by was acquired in the early 1880s. These ad hoc and not altogether satisfactory arrangements were remedied in 1890-1 when a new purpose-built fever hospital was constructed on the adjoining ground. The plans were drawn up by the local architect, Thomas Smith Peace senior. The new fever hospital had three wards and 14 beds together with staff accommodation.³

The second Balfour Hospital built in the 1920s and known as the Garden Memorial Building, *photographed in June 2025 ©️ H. Blakeman*

The second Balfour Hospital was built in the 1920s following a proposal first made in March 1914 when the widow and family of Robert Garden offered funding for the purpose. Robert Garden had made his fortune in retail, with a fleet of cargo vessels and floating shops serving the islands. His widow, Margaret Garden, wrote to inform the Balfour Hospital Trustees of her family’s wish to present a hospital of ‘up-to-date design’ as a gift to Orkney, adding that details regarding the building, accommodation and site were already under consideration.⁴

Central entrance block of the Garden Memorial Building, *photographed in June 2025 ©️ H. Blakeman*

The outbreak of the First World War a few months later meant that the project was put on hold and seemingly not taken up again until 1926. The new hospital became known as the Garden Memorial Building and provided 19 beds in two six-bed wards, single rooms and a bed for maternity cases, as well as the usual offices, staff accommodation, out-patients department and operating theatre. The old Balfour and fever block seem to have continued in use for some years after the opening of the new hospital, but had closed by 1938 and was sold in 1940. In 1943 the original hospital became the West End Hotel, which is remains to this day, while the former fever hospital has been converted to housing.

Possibly one of the former EMS hutted ward blocks to the rear of the Garden Memorial Building, with later additions and alterations, *photographed in June 2025 ©️ H. Blakeman*

Wider view of the rear of the second Balfour Hospital, *photographed in June 2025 ©️ H. Blakeman*

*The former Balfour Hospital from the large-scale OS map revised in 1964, CC-BY (NLS)* *The long blocks on the north side are the additions during the Second World War and the buildings in the photograph above are on that site.*

During the Second World War two hutted ward blocks were added to the rear of the Garden Memorial Building as part of the war-time Emergency Medical Scheme. These provided 84 beds on war-time standards – the beds more densely packed than in peace time. Another temporary ward block of timber was added, but was used for staff accommodation in addition to the nurses’ home. Post-war additions included a maternity unit in 1966 and a health centre in the early 1970s. The latter was officially opened in April 1973 by Sir John Brotherton, the Chief Medical Officer for Scotland.

Post-war addition on the east side of the second Balfour Hospital, with ‘Night Entrance’ to left, *photographed in June 2025 ©️ H. Blakeman*

*Early 1970s Health Centre* to south-west of the Garden Memorial Building at the Balfour Hospital, *photographed in June 2025 ©️ H. Blakeman*

There are also some later blocks to the rear of the site, possibly a laundry and/or boiler house that look to have been added in the 1980s-90s. All the buildings are low-rise, mostly single storey, and a good example of the incremental expansion of a small general hospital in the twentieth century. The site is currently (June 2025) surrounded by security fencing and the buildings mostly empty.

Service building to rear of second Balfour Hospital, possibly a laundry, possibly 1980s, *photographed in June 2025 ©️ H. Blakeman*

Apart from the Balfour, there are two other surviving former hospitals in Kirkwall: Eastbank, a sanatorium and infectious diseases hospital established by Orkney County Council in 1936-7, and the Orkney County Home, built as a poorhouse in 1883 but which had some maternity beds and beds for the chronic sick in the mid-twentieth century.

Eastbank House, Kirkwall, *photographed in June 2025 ©️ H. Blakeman*

Eastbank Hospital comprised two ward blocks built to either side of a substantial private house of twenty rooms, with cottage and outhouses standing on two acres of ground. The Council had previously acquired the seaplane station at Scapa after the First World War, first used as a temporary isolation hospital in 1920 and later adapted as a tuberculosis hospital opening in 1924. The new hospital at Eastbank opened in 1937 with 40 beds: 24 in the infectious diseases block on the north side of Eastbank house, and 16 in the TB block to the south, where most rooms opened out onto a veranda that faced south-west.

Former isolation block, Eastbank Hospital, *photographed in June 2025 ©️ H. Blakeman*

Building on the site of the TB sanatorium block on the Eastbank Hospital site, possibly the altered original ward block, *photographed in June 2025 ©️ H. Blakeman*

*Eastbank Hospital on the large-scale OS map revised in 1964 CC-BY (NLS)*

The poorhouse opened in 1883 with accommodation for 50 paupers, the plans having been drawn up by Thomas Smith Peace senior. There had been a few small poorhouses dotted about the islands previously, while some paupers were boarded out with families or were able to gain ‘out-door relief’ (money from the Guardians to enable the poor to remain in their own homes). Birsay and Harray on the Mainland were operating a poorhouse by 1861 near Douby. At the south of Kirbister there was a parish poorhouse for Orphir, and Deerness parish had a poorhouse near Grindigar. On Westray there was a poorhouse at Kirkbrae, established in the same year as the Kirkwall poorhouse. This was also intended to provide isolation for infectious cases. It was a small building of four rooms. There were similarly small poorhouses on Papa Westry and Sanday.⁵

*Orkney Home, the former poorhouse building, photographed in about 1989.*

The Kirkwall poorhouse became known as the County Home by the early 1940s when it had 52 beds and accommodated a mix of the elderly, infirm, chronic sick, ‘mentally impaired’, and neglected children as well as two maternity beds. The building had outwardly changed little in the later 1980s, but within the last twenty years has been converted to flats, raising the single storey side and rear wings to the same height as the central two-storey range. New sheltered housing has been built to the rear of the old poorhouse.

Former Orkney Home, with major additions and alterations as part of its conversion to housing, *photographed in June 2025 ©️ H. Blakeman*

During the twentieth century there were various moves to reform medical care in Britain. One that addressed the particular problems of caring for the sick in the remoter parts of Scotland was the Highlands and Islands Medical Service, established during the First World War. This scheme had released government funding to improve the health services in remote areas where it was difficult to recruit medical staff. The resident surgeon at the Balfour Hospital in Kirkwall had been appointed through the scheme. The most radical reform, of course, was the establishment of the National Health Service in 1948. In order to provide a free and equitable service to the entire population it was first necessary to understand the nature and extent of the existing health services. Even before the exact form of the NHS had been decided upon, steps had been taken to establish the condition and function of existing hospitals. A national survey had been carried out during the Second World War, begun in 1942. The results of the survey were published in 1946. The reports on Orkney and Shetland form an appendix to the volume covering the North-Eastern Region of Scotland.

*Part of the new Balfour Hospital. The attention to outside space is noticeable, with sheltered planted garden areas such as the above*, *photograph* ©️*H. Blakeman*

*Ground floor schematic plan of the Balfour*

The Survey acknowledged that the main problem on Orkney was its isolation from the larger medical centres and recommended that a re-organised hospital service should link Orkney more closely with one of the mainland regions. The traditional link had been with Edinburgh, largely because many Orkney doctors were Edinburgh graduates and many Orkney families had relatives in Edinburgh. Some patients were sent to Aberdeen, and Orkney County Council had an agreement with Aberdeen Town Council to use the pathology service based at the Aberdeen City Hospital. As a result of the recommendations in the Survey, when the NHS was established Orkney became part of the North-Eastern Regional Hospital Board centred on Aberdeen. This set up a formal connection with the Aberdeen hospitals to provide a much fuller service for the islands, including regular visits by specialists from Aberdeen to Kirkwall, and access to specialist hospitals in and around Aberdeen for patients from Orkney.

*The side of the new Balfour Hospital with a glimpse of the children’s play area behind the hedging on the left. Photograph ©️ H. Blakeman*

The administrative structure established in 1948 remained in place until the mid-1970s NHS reforms which abolished the regional boards, replacing them with smaller health boards. The Orkney Health Board was the smallest of all with just two hospitals: the Balfour and Eastbank (Shetland Health Board administered three hospitals, while the Western Isles Health Board covered five hospitals.) When Eastbank Hospital closed in March 2000, the Health Board administered just the one hospital. In 2004 Orkney Health Board became NHS Orkney, but remains the smallest territorial health board in Scotland.

Notes – see also the Orkney page of the website

History of Parliament online: Orkney Herald, 21 March 1914, p.4 ↩︎
Historic Environment Scotland, List Description; R. H. Hossack, Kirkwall in the Orkneys, Kirkwall, 1900, pp 348-58. ↩︎
Orkney Herald, 19 June 1889, p.5; 25 Sept 1889, p.4; 6 Aug. 1890. ↩︎
Orkney Herald, 18 March 1914, p.4. ↩︎
see workhouses.org for more information on the former poorhouses on the Orkney islands ↩︎

Herefordshire’s Historic Hospitals

October 19, 2024October 21, 2024 / Harriet Richardson / Leave a comment

Over the last year I have been revising the pages on this website that cover the hospitals in England. I am aware that some of the county pages have little more than a list of sites. Herefordshire was one that had very little information about any of the buildings, but it has now been revised with maps, brief histories and illustrations. This post gives a quick summary of the historic hospitals of Herefordshire and the present status of those buildings.

*Hereford General Hospital from the Annual Report for 1927, from the Wellcome Collection*

Hereford General was the first hospital in the modern sense to be established in the county. It was founded in 1776 and occupied adapted premises in Eign Street. Its success warranted a permanent structure for which a site was given by Lord Oxford (Edward Harley, the third Earl of Oxford and Mortimer, who was MP for Leominster and Droitwich). Building work began in 1781 to designs attributed to William Parker and was completed in 1783.

*Former Herefordshire General Hospital, photographed in 2013 © Stephen Richards from* ***Geograph***

The original building survives at the heart of the site, comprising the central nine bays with advanced pedimented centre. It has been much extended and altered, upwards and outwards, including the entrance porch that was added in 1887 at the same time as the Victoria Wing. By the middle of the twentieth century the site was heavily built over, apart from the open ground immediately in front of the original range overlooking the River Wye. A good sense of way in which the hospital evolved can be gained from a short film made in 2002, as the hospital faced closure, which gives the viewer a guided tour both outside and in (see Hereford Focus on YouTube).

*Victoria Ward, Hereford General Hospital, from the Annual Report for 1928, from the Wellcome Collection*

Hereford General remained the main acute hospital for the county throughout the nineteenth century and into the twentieth. The main alternative was Hereford Union Workhouse, which would have had some accommodation for sick paupers from when it was first built in 1836-7. New infirmary wings were built on the site in 1876 and in the early 1900s, but the main transformation came after the Local Government Act of 1929 which saw many former workhouses transformed into municipal hospitals. For Hereford this resulted in its development into the present Hereford County Hospital, initially with a new hospital range begun just before the Second World War. Shortly after the war broke a series of hutted ward blocks were built on the site as part of the Emergency Medical Scheme to provide for the anticipated large numbers of casualties.

*Hereford County Hospital. Part of the former workhouse buildings remaining on the site, photographed in 2008 *© Jonathan Billinger* from Geograph*

Hereford also had a number of specialist hospitals. The Victoria Eye and Ear Hospital opened in 1889, a handsome Tudor style building designed by the local architect E. H. Lingen Barker. Hereford Town Council also provided for infectious diseases with hospitals at Tupsley while the wider county was served by a sanatorium for tuberculosis near Ameley in a converted house (Nieuport Sanatorium). Provision for maternity cases was increasing in the 1940s, as hospital births began to be more common than home births. The County Hospital had a maternity department that was being extended at the end of the war, and there was a small public maternity ward at the General as well as a few private beds. There were also a few maternity beds at all but Ledbury of the former workhouses, while for private paying patients there was a maternity home in Hereford with four beds.

*Former Victoria Eye Hospital, now converted to housing. Photographed in the* *early 1990s © L. Holmstadt*

There was also the county mental hospital, St Mary’s, at Burghill, first opened in 1871 and a ‘mentally deficiency’ institution at Holme Lacy House that opened in the 1930s. In the rest of the county there were a few workhouses, cottage hospitals and small rural isolation hospitals that were established in the nineteenth century.

*Holme Lacy House, photographed in 2005, © David Dixon*, *from Geograph*

Most of the pre-war hospitals in the Herefordshire are no longer in the NHS estate. Some have been demolished, others adapted to new uses. When the NHS came into being in 1948 the hospitals in Herefordshire came under the Birmingham Regional Hospital Board, which also covered Worcestershire, Warwickshire, Staffordshire and Shropshire. This administrative structure remained in place until the NHS reorganisation of 1974.

*Postcard of the former St Mary’s Hospital, probably from around 1900-10*, *when it was still known as ‘the asylum’.*

Initially the Regional Board was responsible for around 220 hospitals with a total of about 42,000 beds. These were grouped into management units based on function and geographical location. Herefordshire Hospital Management Committee oversaw eighteen hospitals. These were: the General and County Hospitals and the Victoria Eye Hospital in Hereford; St Mary’s Mental Hospital, Tupsley Hospital for infectious diseases and Tupsley Smallpox Hospital; Holme Lacy Hospital for ‘mental defectives’; the cottage hospitals at Ledbury, Leominster, Ross-on-Wye, and Kington; Stretton Sugwas Hospital, near Credenhill; Nieuport Sanatorium; the former workhouses at Ross-on-Wye (Dean Hill Hospital), Bromyard, Leominster (Old Priory Hospital),and Kington (Kingswood Hall). Leominster and Kington were owned by Hereford County Council but the NHS had rights to accommodation under the 1948 National Assistance Act. Nieuport Sanatorium closed in 1951 and the Tupsley smallpox hospital was used as a store. Another smallpox hospital near Bromyard was transferred to the NHS but not used, it was sold in 1952.

*Nieuport House was used as a TB sanatorium by Herefordshire County Council in the 1930s. Photographed in 2007 © Philip Halling, from Geograph*

There are now four NHS hospitals in Herefordshire: Herefordshire County Hospital (the main complex built in 1999-2001, W. S. Atkins Healthcare, with other blocks from 1950s-80s and fragments of the 1830s workhouse), and three community hospitals at Leominster (1899, partly rebuilt 1991), Ross-on-Wye (1995-7 incorporating part of the former workhouse) and Bromyard (1989, Abbey Hanson Rowe Partnership). Mental Health services also operate two in-patient units in Hereford: the Stonebow Unit is on the County Hospital site and is a purpose-built facility erected in 1985 that was recently upgraded, and Oak House in Barton Road, a residential rehabilitation unit in a converted house.

*Stonebow Unit photographed in 2008, © Jonathan Billinger, from Geograph*

Herefordshire in 1945 was still an essentially rural county with no large centres of population. The advent of the NHS was seen as an opportunity to rationalise services, including centralisation, continuing a process that had begun before the war. In order to inform the strategic planning of the hospital service, the Board drew on the Hospital Survey of the West Midlands Area published in 1945 by the Ministry of Health. The Survey did not cover the mental health service which was considered as an essentially separate service with its own legislative basis and at the time there were uncertainties about how it might be integrated within a broader national health service, or even if it should be included at all.

*Former Ledbury Cottage Hospital, converted to apartments in 2009. Photographed in 2016 © John M. from Geograph*

The future of cottage hospitals was particularly threatened by the wider policy for modernisation, centralisation and rationalisation. The Hospital Survey of 1945 noted that Ross-on-Wye cottage hospital had 16 beds, plus ‘a few beds in huts in the garden’, Leominster had 13 beds, Ledbury 12 and Kington just 10 beds. There had also been a cottage hospital at Bromyard, but financial difficulties had led to its closure during the First World War. The others lasted longer. Ross-on-Wye Cottage Hospital was replaced by the new community hospital built on the site of the old workhouse. It was demolished after closure in 1997 and replaced by retirement flats. The original Leominster Cottage Hospital partly survives, absorbed by the present community hospital. Its ward block was demolished to make way for the new hospital building which opened in 1991. Ledbury Cottage Hospital was converted to mixed residential and business use in 2009, having closed in 2002. The Victoria Cottage Hospital at Kington is now Kington Youth Hostel.

*Former Bromyard Hospital, now Enderby House, photographed in 2021* © J. Thomas, from **Geograph**

The Hospital Survey also noted that five former workhouses in Herefordshire had chronic sick wards: Leominster, Ross, Kington, Ledbury and Bromyard. Leominster workhouse, like Kington Cottage Hospital, has become a youth hostel (the workhouse had incorporated some fifteenth-century priory buildings). Ross-on-Wye union workhouse developed into Dean Hill Hospital for geriatrics and mental health unit, and had 157 beds by the mid-1960s. The workhouse buildings have partly been demolished to make way for the present community hospital. Kington and Ledbury Workhouses were not transferred to the NHS. Kington has been demolished and Ledbury partly demolished, but some of the workhouse ranges were converted into housing. Bromyard Workhouse has also been turned into flats, not with great sensitivity.

*The former Medical Superintendent’s House of St Mary’s Hospital, photographed in 2011 © Philip Pankhurst from Geograph*

The largest hospital in the county was St Mary’s, built as the City and County Asylum. It closed in 1994 and in 1998 most of the hospital buildings were ‘stupidly demolished’ (according to the Pevsner Architectural Guide) to make way for a large housing development. The entrance building (St Mary’s House) remains along with sections of the ward wings which were converted to flats.

More information on Herefordshire’s hospitals can be found on the Herefordshire page. There is also more on the workhouses on the workhouses.org site. Archival records relating to the hospitals are mostly at Herefordshire Archive and Records Centre, and I would also recommend the Herefordshire Through Time website, which has a section on hospitals. Historic England Archive has the hospital reports and building files that were put together for the national survey of hospitals carried out in the early 1990s on which I worked (though not on Herefordshire). The files may contain photographs of buildings that were standing then but have since been demolished.

Hertfordshire Hospitals Survey Revisited

October 4, 2024October 5, 2024 / Harriet Richardson / Leave a comment

Hertfordshire was one of the counties covered by the London team of the national hospitals survey, carried out in the early 1990s by the Royal Commission on the Historic Monuments of England. The London team comprised myself and Colin Thom (now Director of the Survey of London). At that time we only investigated hospitals built prior to the inauguration of the NHS in 1948 – so major post-war hospitals, such as those at Welwyn and Stevenage, were excluded.

*Welwyn Garden City’s early post-war general hospital was demolished in 2017.* *Photograph from in February 2017 © Gerry Gerardo, on* **Geograph**

Fieldwork for the survey was carried out in 1991-3. There was not enough time to visit every single site, and some were considered in greater detail than others. The selection had as much to do with ease of access as it did with the historic significance of the buildings. This meant that some ‘important’ sites were either missed out or only briefly dealt with. I am puzzled now as to why some weren’t visited. In Hertfordshire we seem not to have managed to get to Welwyn, Royston or Hitchin, and also didn’t photograph Letchworth Hospital. The rest we visited on various dates between May 1992 and June 1993, while also covering the rest of the South East (Greater London, Essex, Kent, East and West Sussex, and Surrey) as well as Avon, Staffordshire, Shropshire and parts of the West Midlands, added late on to help out the York-based team. We covered a lot of ground, so perhaps I shouldn’t be too surprised that I’m struggling to remember visiting some of them.

For each site a building file was created, and these can be consulted in Historic England’s Archive based in Swindon. (The reference numbers for the files can be found on each of the county pages of the gazetteer after the name of the hospital following the grid reference.) These files vary in content, but generally have a report, photographs and maps.

Follow the link to the Hertfordshire page of this website for more details of individual sites.

What does Pevsner say?

The best known architectural guide to the buildings of Britain is the series begun by Nikolaus Pevsner after the Second World War. The Pevsner guides are generally the first place to look for information about the historic buildings throughout the UK. The original Pevsner guide to Hertfordshire was published in 1953, with an extensive revision published in 1977 (revised by Bridget Cherry). A further revised guide with new material edited by James Bettley was published by Yale University Press in 2019. I have relied heavily on this for updates to the condition of the various hospitals that we visited back in the 1990s. However, hospitals, especially former hospitals, are not easy to find in the guides and often receive only cursory mentions, if any at all. It is not a reflection of their historic significance as public buildings, but rather their relatively lowly architectural status, as they were seldom designed by ‘top’ architects, many are more interesting for their plans than their outward appearance, and where there have been many additions and alterations they can seem muddled and incoherent.

*Original central administration block of West Herts Hospital, Hemel Hempstead, from the 1870s rebuilding of the infirmary. Photographed in 2018 © Dormskirk* *CC BY-SA 3.0*

In its introductory overview, the guide notes that the first purpose-built hospitals appeared around the same time as the first workhouses built after the Poor Law Amendment Act of 1834. The West Herts Infirmary at Hemel Hempstead was built in 1831-2 followed swiftly by Hertford’s County Hospital in 1832-3 to designs by Thomas Smith. In 1840 Hitchin Infirmary was built designed by Thomas Bellamy. The last two have since been replaced, and only the core of their original buildings has been retained. Bellamy’s Hitchin Infirmary is now Bellamy House – the remainder of the site now occupied by a Waitrose supermarket. Hertford County Hospital has been replaced by a new building constructed alongside in 2003-4 (architects Murphy Phillips) leaving the old building rather marooned. West Herts is a typical multi-phase hospital, with much of its built heritage remaining in use, including the early Cheere House of 1831 and Coe and Robinson’s 1875-7 pavilion-plan infirmary (see photo above).

*Former Watford Union Workhouse from Vicarage Road, photographed in May 1992. The former workhouse building became part of Watford District General Hospital © Harriet Blakeman*

As well as general hospitals, there was a private asylum at Much Hadham established around 1803 (principally of architectural interest to the Guide because it occupied The Palace), and a crop of workhouses. Of the latter, there are partial survivals at Buntingford (1836-7 by W. T. Nash); St Albans (1836-7 by John Griffin); Ware (1839-40 by Brown & Henman) and more substantially at Watford (1836-7 by T. L. Evans) where the workhouse developed into the general hospital.

*Architectural aerial perspective view of proposed asylum, Leavesden*, *from* The Builder

During the Victorian and Edwardian eras Hertfordshire attracted children’s homes and mental hospitals, including the Metropolitan Asylums Board’s ‘Imbeciles’ Asylum’, later Leavesden Hospital, at Abbots Langley designed by John Giles & Biven and built in 1868-70. This asylum was the twin of Caterham Hospital which served the south of the Metropolitan area.

*View looking up the central spine of the hospital with the ends of the ward pavilions to the left, water tower on right.* *All of the buildings in the photograph were demolished as part of the redevelopment of the site. © Harriet Blakeman*

Of Leavesden Hospital only the former administration block, chapel and recreation hall have been retained, converted to the residential Leavesden Court – a gated development – with new housing built to the north and west on the site of the former ward pavilions and parkland to the east.

Setting aside children’s homes, the Guide also notes Holman & Goodrham’s TB sanatorium built for the National Children’s Home built in 1909-10 (survives as the King’s School); Rowland Plumbe’s Napsbury Hospital built in 1901-5 (partially demolished, parts converted to housing); and G. T. Hine’s Hill End Asylum of 1895-9 (largely demolished). The only ‘local hospitals’ during this period mentioned in the Pevsner Guide are the cottage hospital at Watford of 1885 designed by C. P. Ayres (still extant) and the Sisters Hospital at St Albans designed by Morton M. Glover of 1893 (later extensions demolished, original main buildings converted to housing).

One of the former ward blocks of Hill End Hospital, photographed in May 1992. Only the chapel and the southernmost blocks were retained when the site was redeveloped for housing. *© Harriet Blakeman*

In the 1920s Royston Hospital was built to designs by Barry Parker (still an NHS hospital, but much extended). Then in the 1930s the large new mental hospital at Shenley was built, designed by W. T. Curtis (mostly demolished), and ‘a rather utilitarian general hospital’ at Welwyn designed by H. G. Cherry (still an NHS hospital with a newer block built to the south).

Part of the former Shenley Hospital, photographed in May 1992, now demolished, *© Harriet Blakeman*. Only the chapel, medical superintendent’s house and one small accommodation block were retained

The chapel at Shenley Hospital, photographed in May 1992 *© Harriet Blakeman*

There is no mention in the introduction of the post-war hospitals, and the Lister at Stevenage is quickly covered by two sentences that provide the date (1966-72), the architect (E. A. C. Maunder of the North West Metropolitan Regional Hospital Board) and summary of its appearance (A central Block of nine storeys, a symmetrical elevation with projecting balconies, surrounded by extensive lower buildings.) Before too long, I hope to produce a separate post on the Lister and the other post-war hospitals in Hertfordshire.

Hertfordshire Hospitals in the 2020s

Hospital services in the 21st Century have become significantly more complex since the early years of the NHS. The NHS currently has thirteen hospitals in the county (not including those that were formerly in Hertfordshire which now lie within Greater London – such as in Barnet). There have been at least 44 hospitals in Hertfordshire in the past, not including a few small local authority hospitals for infectious diseases. The decline in the number of hospitals reflects increasing centralisation of services and changing practices in medical care and treatment. Of the 44 that feature in the Hertfordshire gazetteer page, only five are still NHS hospitals; 15 have been converted to housing or other use, including partial demolition; and 24 have been either entirely or largely demolished. The scale of demolition is larger than even that figure suggests, as it includes some of the largest hospital complexes in the county.

*Former Harperbury Hospital, photographed in May 1992 © Harriet Blakeman*

It has been depressing to discover the extent of destruction of former hospital buildings, a great many of them only having been demolished in the last ten to twenty years. A great deal more should and could have been retained, particularly of the large former mental hospitals such as Shenley, Harperbury and Hill End.

*Former St Pancras Industrial Schools that became part of Abbots Langley Hospital, photographed in the early 1990s, now demolished. © Harriet Blakeman*

Leavesden Hospital, as mentioned above, has largely been demolished to make way for housing. The hospital also had an annexe to the south. This had formerly been the St Pancras Schools, together with detached hospital and babies home. It had an Emergency Medical Scheme spider block built at the start of the Second World War on vacant ground behind the buildings which became Abbots Langley Hospital when transferred to the NHS in 1948. These emergency hutted buildings were intended to be temporary, and it is perhaps more surprising that they lasted into the 1990s than that few of them are left in the 2020s.

*The wartime extension of EMS hutted ward blocks* *at Abbots Langley Hospital, photographed in the early 1990s, now demolished. © Harriet Blakeman*

I have always had a few favourite hospitals – ones that were particularly attractive or interesting. In Hertfordshire, Shenley was one – at least in part because of its lovely grounds. The hospital was laid on the Porters Park estate, along with the mature landscape around the mansion house.

Porters Park mansion was adapted for convalescent patients at Shenley Hospital. *© Harriet Blakeman*

Porters Park has a complicated history having been substantially rebuilt or remodelled on more than one occasion. Its present appearance is largely due to the rebuilding of 1902 for C. F. Raphael by the architect C. F. Harold Cooper. The house and estate were transformed into Shenley Mental Hospital in the 1930s. The map below show the extent of the hospital in the 1950s. It was designed on a colony plan, whereby all the patients’ accommodation and treatment blocks were detached, and arranged in the manner of a village, with central service buildings and chapel.

*Shenley Hospital on the OS map surveyed in the 1950s CC-BY (NLS)*

The map below shows the modern housing development on the site. The existing buildings are shaded orange. The map is overlaid on the 1950s OS map above – and the grey shapes of the hospital blocks can just be seen behind. Only the PW – place of worship – and the small block to its south are from the hospital era.

*Overlay map of Shenley showing the new housing development on the former hospital site. OS map of the 1950s* *and OS Opendata CC-BY (NLS)*

Napsbury was another favourite – here too the landscape setting was particularly good, but the architect for this large asylum, Rowland Plumbe, was allowed to bring his characteristic style to the buildings, which were more decorative than Hine’s more pedestrian Hill End. The picturesque qualities of Napsbury no doubt made its adaptation appealing for the developers of the site, and it is now at the heart of Napsbury Park – a residential development near St Albans largely constructed between 2002 and 2008 (see blog post on Napsbury here).

One of the detached villas at Napsbury Hospital, photographed in the 1990s. Sadly, this villa was demolished *© Harriet Blakeman*

If I had to name a top three of Hertfordshire hospitals, Napsbury would probably be at number one, with Shenley at number two. At number three I would put Bennett’s End – and I was particularly saddened to see that this one has been demolished. It was the perfect small local authority isolation hospital, built in accordance with the Local Government Board’s model plans.

*Aerial perspective of Bennett’s End Hospital published in 1914*, *the hospital looked remarkably similar to this when we visited in the 1990s.*

*Bennett’s End Hospital, administration block © Harriet Blakeman*

There were a few other losses that I am particularly saddened by. Potters Bar Hospital was a charming low-rise late 1930s Deco-ish building that has been replaced by a Tesco supermarket. A new Community Hospital was built on Barnet Road.

*Potters Bar and District Hospital, Mutton Lane, built* c.1938, *closed 1995 © Harriet Blakeman*

I was also shocked to find that I had missed Welwyn Garden City’s Queen Elizabeth II Hospital, demolished in 2017 after the new QEII was built on the adjacent site. The original QEII opened in 1963 and was one of the first new general hospitals to be completed by the NHS. There is a little more information on the Hertfordshire page.

*Model of the* *Welwyn-Hatfield new hospital, published 1958 by the North-West Metropolitan Regional Hospital Board*

It has been a sobering exercise, revisiting the survey of Hertfordshire’s hospitals. Far more has gone than I had anticipated. We knew at the time that the NHS was winding down the majority of the large former mental hospitals in England. There had also been an increase in hospital-building during the 1980s with many ‘nucleus’ district general hospitals being built. Together this contributed to a great many hospital closures and redundant buildings. Replacing the older pre-war hospitals had been an early ambition of the new NHS in 1948, but it has taken most of the second half of the twentieth century to come close to that ambition.

Astley Ainslie Hospital, Edinburgh

August 30, 2024August 30, 2024 / Harriet Richardson / 1 Comment

Astley Ainslie Hospital, gates by Thomas Hadden, photographed February 2024, © H. Blakeman

This post looks at the early history of the Astley Ainslie Hospital and the development of a more scientific approach to convalescence in the early twentieth century.

*The balcony and veranda on the south side of the new ward wing added to Canaan Park House, from* The Nursing Times, *9 Jan. 1926*

The Astley Ainslie Hospital is the main rehabilitation hospital in the NHS Lothian region. There are buildings of various dates, from the early 19th century to the early 21st century on the large site in the Grange area of Edinburgh. The hospital was established for convalescent patients from the Royal Infirmary of Edinburgh by a generous bequest from David Ainslie. The site comprising four large villas and a golf course was acquired in 1921, and the architect John Jerdan commissioned to adapt one of the villas – Canaan Park – as the first phase of turning the new hospital. The house became the main administration department with a new wing added to the south for 34 female patients under the charge of Dr (Isabella) Mary Mears, the resident medical officer.

The first patients were admitted in 1923, and three years later the Nursing Times provided a description of the new institution along with a photograph of the recently built ward unit (see above). The article noted the beautiful grounds, with fine view to the Braid Hills, and that the new ward unit was ideally suited to its purpose of a ‘convalescent retreat’. Although the Astley Ainslie was intended for patients from the Royal Infirmary it was independently run, with its own body of governors, as intended by its benefactor, David Ainslie. It was on his instruction that the hospital was named after John Astley-Ainslie, David Ainslie’s nephew who had died at the young aged of 26. It was also intended that the institution should be for cases that required longer care than was provided at the Infirmary’s existing convalescent home at Corstorphine (see the Edinburgh page for more details).

*Canaan Lodge, Millbank, Canaan House and Canaan Park, on the 25-inch OS map surveyed in 1893 reproduced courtesy of the National Library of Scotland, CC-BY (NLS)*

The Nursing Times described the entrance hall of Canaan Park House as having a piano and that it was ‘bright with pots of growing chrysanthemums’. The colour scheme generally was white and green – colours chosen for their calming and restful qualities. No operations were to be conducted at the hospital, but post-operative treatment, such as changing dressings, was one of the potential nursing duties. Initially the patients were generally surgical, tuberculosis or adolescent heart cases. The wards were ‘big, bright, airy places built on the horseshoe plan’, the balcony and veranda were accessed from large French windows, and had five beds on each, with a further twelve within the ward. Some patients slept out on the balcony or veranda in winter and summer. As well as the two wards, the patients had the use of a dining-room that also served as a recreation room.

*Canaan Park House, with the 1920s ward wing on far right. Photographed February 2024, © H. Blakeman*

The ample grounds at the Astley Ainslie allowed out-door recreation including bowls, croquet and clock golf. Patients could also undertake gardening in the vegetable garden. Indoors there was a well-stocked library, while concerts, lectures and entertainments were organised regularly.

*Canaan House* *in 2024*, *© H. Blakeman*

Flowers, fruit and vegetables were supplied from the gardens, and the original gardeners to the large houses were retained with a view to preserving the ‘old-world appearance’ of the grounds. An ample supply of fresh produce was a vital part of providing patients with a nutritious diet, with a stress on milk, butter, eggs, green vegetables and fruit. A considerable part of the estate was laid out as a kitchen and fruit garden in order to maintain a constant supply. The best diet for convalescents was an ongoing subject of study. Early experiments at the Astley Ainslie in trying to encourage patients to consume plenty of green vegetables, especially when raw – such as lettuce and tomatoes – was too much of a novelty for some, being ‘often neither appreciated nor eaten without persuasion’.[J. Cunningham, Edinburgh Medical Journal, 1931 v.38 (9), p.146.]

*OS map revised 1913, part of site acquired for the hospital CC-BY (NLS)*

The beneficial effects of nature, of fresh air, sunlight and pleasant grounds, had long been recognised as an important part of the therapeutic treatment of convalescent patients and before the development of effective drugs to treat tuberculosis had been shown to slow the progress of that disease in some patients. Sanatoria were designed with sun-trapping angled plans – a butterfly, or half-butterfly plan – with verandas in front onto which beds could be wheeled. This was the form adopted for the new blocks built in the hospital grounds, but even in the first ward extension to Canaan Park House a sun-trap was created where ‘screen-enclosed, sun bathing takes place in summer’ and a wooden shelter was built where patients could sit out and enjoy ‘the wintry sunshine, each clad in a big coat and wrapped about with a warm fleecy blanket’.

*East Pavilion, north elevation, photographed February 2024 © H. Blakeman*

Two neighbouring villas were acquired in the 1920s to extend the site: Morelands and St Roque House. In the second half of this decade the first two new hospital blocks and a nurses’ home were constructed. For the design of the new buildings the governors turned to the architects Auldjo Jamieson and Arnott, who had taken over the practice of Sydney Mitchell and Wilson, architects of many hospital buildings including extensions to the Royal Infirmary. The grandly named and wealthy Ernest Arthur Oliphant Auldjo Jamieson (1880-1937) had worked in Mitchell and Wilson’s office early in his career before setting up on his own account around 1909-10, but soon after the two practices were merged and James Alexander Arnott (1871-1950) joined as a partner.

*OS map revised 1932 showing the East and West Pavilions, Scientific block, Kitchen Block and Nurses’ Home CC-BY (NLS)*

The 1920s hospital blocks (now the East and West Pavilions) were single-storey, butterfly-plan buildings built on the site of the ladies’ golf course (see maps above and below). The slope of the site gave uninterrupted views of Blackford Hill to the south.

*Millbank Pavilion, south elevation, photographed February 2024*, © *H. Blakeman*

A third butterfly-plan pavilion was built on the site of Millbank House which was acquired by the governors around 1930. At the same time a new main entrance to the site was created on Grange Loan with its fine wrought-iron gates made by Thomas Hadden in his characteristic Arts & Crafts style of flowing natural forms (see photographs at the top of the post and below). The gates were hung between square sentry pavilions with pyramidal roofs and over-sized circular window.

*The ornamental wrought iron gates made by Thomas Hadden, photographed when newly installed, image from HES Archives*

The nurses’ home was completed in 1930, a two-storey and attic, H-plan building, built on the site of South Bank House, just west of the former golf course. Plans of the home had been drawn up by 1925 when they were published in the Architects’ Journal. It followed the conventions of the time, with single bed-rooms for 45 nurses and shared bathrooms and toilets on the upper floors, and communal recreation rooms on the ground floor.

*Nurses’ Home, north elevation, photographed February 2024 © H. Blakeman*

Just north of the nurses’ home a central kitchen block was built, now the Blackford Pavilion and still functioning as a kitchen and canteen. It also houses NHS Lothian’s health promotion Resource Centre. A covered corridor connects the centre to the nurses’ home.

*The Blackford Pavilion* *© H. Blakeman*

A scientific block was amongst the early buildings at the Astley Ainslie, reflecting the governors’ decision that the institution should act as a centre for investigating the problems connected with convalescence and the greater prominence of rehabilitation in the years after the First World War. The large numbers of military personnel who became disabled in action led to developments in prosthetics and a range of treatments or therapies. The scientific block was designed in more formal style than the ward pavilions, its south front featuring an arcade of Grecian Doric columns within which the main entrance sits behind a pair of columns set in Antis. It housed a gymnasium for physiotherapy (at the time termed ‘massage’ and remedial exercises – a reminder of physiotherapy’s origins in ‘Swedish Gymnastics’). It also had an electric department with x-ray equipment, rooms for ultra-violet radiation and electric therapeutics, a dentist’s room, dispensary and research laboratory. Heliotherapy was an important part of convalescent treatment, but the unreliability of the weather soon led to the addition of an artificial sunlight lamp.

*Scientific Block, photographed February 2024, © H. Blakeman.*

In April 1929 Lieutenant-Colonel John Cunningham was appointed as the Medical Superintendent of the Institution. He delivered a number of papers about the new science of convalescence to the Edinburgh Medical Society that were subsequently published in the Society’s journal. In a paper of 1931 he noted that the organised study of convalescence and the methods of dealing with it were of recent growth, and that there were few publications on the subject. Historically the main ingredients of successful convalescence were ‘moderation in exercise, peace of mind, tranquil sleep, and proper hygiene’. [Cunningham, ‘The Convalescent State’, Edinburgh Medical Journal, 1931, vol.38 (9), p.137.] However, until at least the mid-19th century, convalescence had been available only to the rich – ‘the poor man had no time to be sick, and still less were facilities for recovery provided for him’. [Idem. p.138.]

*View of the Scientific block from the west* *© H. Blakeman*

The earliest convalescent hospital founded in Britain was probably the Metropolitan Convalescent Institution, founded in 1841 and later moving to purpose-built accommodation at Walton-on-Thames (later named Ellesmere Hospital, see the Surrey page for more details). The type of convalescent home that developed concentrated on cases that were already well on the way to recovery. Most were unable to take patients who required active medical attention.

*Metropolitan Convalescent Institution, later Ellesmere Hospital, Surrey Wellcome Collection*

The Health Insurance Acts improved access to basic convalescence to the working classes (see Convalescing in Colwyn Bay for more details). There had long been an economic advantage to giving the work force a proper opportunity to convalescence – both from an employers’ point of view and for hospitals. Apart from freeing beds in an acute hospital by transferring convalescents to a different setting, the relative cost per bed of a convalescent home was significantly less than for an acute hospital.

During the First World War convalescent establishments were provided as well as hospitals for the military. This spurred advances in the study and treatment of convalescence, as well as bolstering the arguments for separate convalescent institutions that were specially designed and equipped for the purpose. Classification of convalescent patients was developed to outline the different requirements of particular groups, such as cardiac, orthopaedic or psychiatric.

*Occupational Therapy Unit, photographed February 2024 © H. Blakeman*

By the 1920s America was forging ahead in refining the treatment of convalescents. The main sources of information were publication by John Bryant in the 1920s, and the example of the Burke Foundation near New York. The Burke Foundation had 300 beds and dealt with many cases previously excluded from convalescent homes, such as chronic illness and physical disabilities. Occupation and recreation as aids to recovery played an important role. There are cross-overs here with therapies in psychiatric hospitals of the time and particularly in institutions for those with learning disabilities, but the benefits of encouraging some form of occupation for convalescent patients had been recommended by many, including Florence Nightingale. Occupational therapy developed during the First World War, when it was shown to have positive effects on mental wellbeing (or in the language of the time, ‘mental tone and preventing moral deterioration).

One of the pioneering advocates of occupational therapy in Britain was Sir Robert Jones, who noted the lesson learnt during the First World War of the psychological and physical value of work. Workshops for wounded soldiers filled the hours when they weren’t undergoing treatment, usefully distracting their minds. The Canadian war hospitals were some of the first to place ‘Occupational therapy’ on an organised basis, while some of the earliest training schools for occupational therapists were established in Canada and the United States. The Astley Ainslie was one of the first to establish a school of Occupational Therapy in Scotland.

In a future post I will look at some of the later developments at the hospital.

St Vincent’s Hospital, Kingussie

August 16, 2024 / Harriet Richardson / Leave a comment

*St Vincent’s Hospital, photographed in August 2022 © H. Blakeman*

Perched high above Kingussie sits the former St Vincent’s Hospital, empty and vulnerable to the attentions of vandals since it closed in 2021. It was replaced by the new Badenoch and Strathspey Community Hospital at Aviemore.

The history of the hospital spans more than a century. It first opened in 1901 as the Grampian Sanatorium, founded by Dr Walter de Watteville who had already begun treating patients on the open-air principle in 1898 at his home ‘Sonnhalde’. De Watteville initially added a wing to his house, with separate entrance. This has some claim to being the first privately instituted TB sanatorium in Scotland.

There was sufficient demand for treatment that de Watteville was able to build a larger sanatorium in 1900 which was opened in June 1901. It occupied a large site, of ten acres, laid out with walks – gentle exercise being part of the ‘treatment’ for TB. Patients were also thought to benefit from inhaling the scent of pine trees – of which there were many in the surrounding woods.

The new sanatorium was designed by the local architect A. Mackenzie, with Alexander Cattanach as the mason. It has a south-easterly aspect, the original bedrooms for the patients all on this side of the building with corridors behind. Their rooms had stained and polished wood floors, walls painted with ‘duresco’ (a water-based paint) and had rounded angles. The furniture was also specially designed. At the ends of the building on the ground floor were larger rooms used as dining and day-rooms. The kitchens were in a service wing at the rear, along with staff accommodation.

The distinctive round-arched windows no longer have their original glazing which were sash windows with a ‘rounded revolving fanlight’ above. Some of the rooms at the centre of the building gave out onto a veranda or balcony, via French doors. The engraved view published in Walters’ Sanatoria for Consumptives (below) shows patients lying on camp beds on the uncovered veranda in front of the hospital. The nature of the revolving fanlights can also be seen: they tilted on side pivots.

*Grampian Sanatorium (later St Vincent’s Hospital) from F. R. Walters,* Sanatoria for Consumptives, *published in 1905.*

The sanatorium was heated by open fires, lighting was by electricity. Dr de Watteville acted as the medical superintendent and his wife as matron, helped by a medical assistant, two nurses and domestic staff. [F. R. Walters, Sanatoria for Consumptives, 3^rd edn. 1905, pp.189-90.]

*Dr Walther’s Nordrach Sanatorium, from F. R. Walters, Sanatoria for Consumptives, published in 1905.*

The inspiration behind the design of the sanatorium, and the treatment conducted within it, was Nordrach Sanatorium in the Black Forest of Germany run by Dr Otto Walther. A small clutch of sanatoria were named after the German hospital in Britain – including Nordrach on Dee, Banchory (later Glen-o-Dee Hospital), and Nordrach upon Mendip, near Bristol.

*St Vincent’s Hospital, rear wing, photographed in August 2022 © H. Blakeman*

In 1917 de Watteville sold the sanatorium to Dr Felix Savy, who increased the capacity of the hospital slightly – from 18 to 27 beds by 1926. Artificial pneumothorax was made available from around 1926, Dr Savy being a pioneer of this surgical technique to collapse the infected lung. He also introduced X-ray equipment, UV light and laboratory facilities.

In 1934 the sanatorium was purchased by the Sisters of the Order of the Daughters of Charity of St Vincent de Paul, although Dr Savy remained as the physician in charge. The Sisters had the rear extension built as living quarters, and created a chapel above the main entrance. The photographer, Oscar Marzaroli, was a patient in the 1940s. The sanatorium was not transferred to the NHS in 1948, although it was used for NHS patients for a few years until the demand for beds for TB cases declined. By the mid-1950s the decline in TB led to many former sanatoria being adapted to new uses. St Vincent’s became a home for the elderly in 1956. As the residents increasingly required nursing care, by the early 1970s the Order planned to create wards for geriatric patients (this may relate to work by J. G. Quigley and Partners, architects, Glasgow noted on the Dictionary of Scottish Architects for 1969-71 for the Sisters.). The interior was remodelled in 1973-4 to convert the ground floor into a geriatric hospital unit, run by Grampian Health Board, while the upper floor remained a residential home run by Highland Regional Council. As part of the works, a large new day room was created at the west side, the old fireplaces and chimneys removed. It was still run by the Sisters of the Order, but finding staff was proving increasingly difficult and in 1986 the home hospital was bought by the NHS. The upper floor was converted to provide a psychogeriatric unit in 1988-9. [J. C. Leslie adn S. J. Leslie, The Hospitals of Badenoch & Strathspey, 2022.]

Tenbury Cottage Hospital

July 8, 2024July 10, 2024 / Harriet Richardson / Leave a comment

I recently acquired this postcard of the cottage hospital in Tenbury. It wasn’t a hospital that I was familiar with, and it seems to have missed out of the RCHME hospitals survey – perhaps because it lies on the border of two counties, Tenbury itself being in Worcestershire while the hospital lies over the river, and over the county boundary, in the Shropshire parish of Burford. Shropshire was one of the counties that I worked on, but this hospital slipped through the net. It’s a pity, not least because it is still an NHS hospital and the original section is a listed building.

Tenbury surveyed for the 25-inch OS map in 1883, the cottage hospital is at the top right, along the road from the Swan Hotel. The main village is south of the river, with Tenbury Union Workhouse the first building to the east of the Teme Bridge. Reproduced by permission of the National Library of Scotland, CC-BY (NLS)

The hospital was established in a converted house in 1869, and originally called St Mary’s Cottage Hospital. The early nineteenth century house was extended westwards around the turn of the century. The extension is probably the part shown on the postcard to the left, with veranda and balcony. In the 20th century the hospital expanded on its east side. It is currently (2024) a community hospital administered by Worcestershire Health and Care NHS Trust.

*The cottage hospital at Tenbury from the 25-inch OS map surveyed in 1883. CC-BY (NLS)*

The original building seems to have been listed because of its interest as a house. It was built around 1835 by Richard Titt, landlord of the Swan Hotel, who died in 1843, aged 86, having been the Swan’s landlord for over 40 years. However, it is also historically important as an early example of a cottage hospital in England, having opened on 1 September 1869. This was only ten years after the very first cottage hospital which opened in 1859: Cranleigh Cottage Hospital, Surrey. It is particularly rare to find a first-generation cottage hospital still using its original building.

*The 1902 OS map shows the small western extension of the cottage hospital. CC-BY (NLS)*

The hospital featured in Horace Swete’s Handy Book of Cottage Hospitals published in 1870. Swete described the hospital as a ‘small villa, with garden, coach-house and stable, altered for the purpose’. Patients contributed a small fee towards the cost of their care and treatment, charged at a weekly rate. Mrs Arabella Prescott served as the lady president of the establishment, and it was she who had purchased the house and footed the bill for fitting it up as a hospital, including the provision of linen, dressing-gowns and slippers for the use of the patients.

*Cranleigh village hospital was the first of its kind, opening in 1859 and featured as the frontispiece of Horace Swete’s* Handy Book of Cottage Hospitals *published in 1870.*

There was no connection to a mains sewer, so earth closets (or ‘earth commodes’ as Swete termed them), were used throughout the hospital. The floors were waxed and polished ‘with a view to greater cleanliness’, but Swete was critical of this, as it might make the floors slippery: ‘A poor fellow getting out on his crutches for the first time, would find considerable difficulty in walking upon it without falling’.

The hospital had a convalescent ward, and the coach-house was converted into a mortuary chamber, top-lit and fitted with a slate-topped table. The nurse in Swete’s time had formerly been a sister at Middlesborough Cottage Hospital. By 1910 the Tenbury cottage hospital had 9 beds, later extended to 12. An extension was built on the east side of the original house in 1912 named the Elizabeth Wing.

In 1915 the hospital featured in Henry C. Burdett’s How to Become a Nurse which listed the requirements for of various hospitals for trainees. St Mary’s, as it was then still known, took on young women for a month’s trial after a personal interview, which if satisfactory, led to one year’s training. Women had to be between 20 and 22 years of age, between 5ft 2in (1.57m) and 5ft 11in (1.80m) in height, with satisfactory evidence as to character and health. ‘Applicants should be of the upper middle class and Church of England’. Training included lectures by the matron on anatomy, and examinations were held twice yearly. ‘Laundry and text-books provided. Separate bedrooms.’

*H. C. Burdett’s* How to Become a Nurse, *1915*

Although the hospital charged fees for admission and subscriptions from wealthier supporters, fund raising was an essential activity. Church collections were the main source of ad hoc donations. The nearby Swan Hotel hosted an ‘invitation charity ball’ in December 1884, and in 1899 and 1900 a ‘guess the weight of a cake’ competition. The Hotel later instituted an annual ball which took place until the outbreak of the First World War. Nevertheless, by the later 1890s the hospital’s income did not meet its expenditure, causing the hospital to dip into its endowment funds.

St Mary’s survived into the 1920s, but had to close in 1928 in the face of rising costs and staffing difficulties. All was not lost, and in 1931 it was re-orgnised and re-opened as Tenbury and District Hospital, with a further extension to the east opened in 1935 to provide an operating theatre. In the hospitals survey conducted by the Ministry of Health during the war it was described as having 16 beds, maintained by the Tenbury and District Hospital and Nursing Association. Six local general practitioners formed the honorary medical officers alongside a general surgeon from Leominster, an ear and throat surgeon from Kidderminster and a dental surgeon.

Under the NHS the hospital was well supported by the local league of friends. Expansions and modernisation improved facilities, and in 1986 a new outpatients department was built. A Millennium Project provided a further extension .

[Sources: Tenbury and District Civic and Historical Society, Tenbury and the Teme Valley People and Places, 2007: Horace Swete, Handy Book of Cottage Hospitals, 1870, pp.161-2: Report of the Royal Commission on the Poor Laws, 1908: Worcester Journal, 5 Jan. 1843, p.3: Wellington Journal, 27 October 1877, p.8: Tenbury Wells Advertiser, 16 Dec 1884, p.4; 31 Oct. 1899, p.5; 30 Jan. 1900, p.5: Kington Times, 6 July 1935, p.4: Ministry of Health, Hospital Survey. The Hospital Services of the West Midlands Area, 1945.]

Stevenage Outpatients’ Centre

April 1, 2022May 3, 2023 / Harriet Richardson / 1 Comment

In the centre of Stevenage, just next to the central library with its adjoining Health Centre, stands this gem of an early NHS building. However, the building is now under threat of demolition as part of the current Stevenage Development Board’s plans to make ‘Stevenage Even Better’. (Surely a potential sequel to W1A?) There has been an outpouring of dismay at this decision on Twitter. Is it too late to hope that this building might be preserved? So many of the early NHS hospital buildings have been demolished, this is becoming an increasingly rare survivor.

*Former Outpatients’ Centre, photographed in 2022 © K. A. Morrison*

It was built in advance of the new District General Hospital, the new Lister Hospital. Well in advance as it turned out, as the outpatients clinic was built in 1959-61 while the residents of the New Town had to wait another ten years or so for the opening of the Lister Hospital.

*The Lister Hospital. Photographed by Peter O’Connor in 2011, CC BY-SA 2.0*

Stevenage Development Corporation reached an agreement with the North-West Metropolitan Regional Hospitals Board in about 1957 for them to build a casualty and outpatients’ clinic on a site to the south of the main shopping core of the New Town. The site formed part of the area reserved for Hertfordshire County Council, offering the opportunity of forming a close link between the clinic and the local authority’s health centre. The County Council agreed to give up part of the land to the Hospital Board in recognition of the need for hospital services in the town, which were provided by the hospitals at Hitchin. These were the former workhouse (renamed the Lister Hospital during the Second World War) and the North Hertfordshire and South Bedfordshire Hospital, the town’s long-established former voluntary hospital. Both of these hospitals had been acquired by the State on the appointed day in June 1948 when the National Health Service was inaugurated.

*Stevenage Outpatient Centre when new, reproduced from* The Hospital, *March 1962. General view showing the gymnasium on the left.*

Plans were approved for the clinic in about 1958 at which time it was anticipated that work would begin on site the following summer. The commission was put out to Peter Dunham, Widdup and Harrison, architects based in Luton, a firm that had some experience with hospital design in Northern Ireland, but also designed some elegant private houses, laboratories and factories. It was not unusual for the NHS to place design work with private firms, especially for larger schemes. Most of the Regional Boards had architects departments, but some were small, and initially under-staffed for the large amount and range of work with which they were faced.

Peter Dunham was born in Luton and had trained at the Bartlett School of Architecture. He had started in private practice in 1933, and served in the Royal Engineers during the war, where he met MacFarlane Widdup. Widdup, a Yorkshireman who had trained in Leeds, was two years older than Dunham. According to the Architectural Review of 1953 he spent his spare time ‘cutting down trees too near his new house, admiring other people’s vintage cars and making amateur films of the kind no-one else understands’. As for the third partner of the team, Michael Harrison was a fellow Lutonian and Bartlett student, who had spent three years in local government before joining Dunham and Widdup in 1949.

*Detail of the corner of the outpatients’ centre showing the different decorative treatment on the north (left) and west (right) sides of the gymnasium. Photographed in 2022 © K. A. Morrison*

Stevenage Development Corporation welcomed the development of the clinic but lamented that instead of building even the first stage of a new general hospital all that the Regional Hospitals Board were able to do were some improvements to the existing Lister and North Herts Hospitals at Hitchin. In their Annual Report published in 1959, the Corporation noted their hopes that the Stevenage Hospital would be given high priority when the country’s economic circumstances permitted new hospital building. The growing population of the area was making it more difficult for the Hitchin hospitals to meet the demands made on them. When the new clinic opened it functioned as an annexe of the old Lister Hospital at Hitchin and provided a full range of consultative and specialist clinics staffed from both the Lister and the North Herts. Since that time it has continued to have an outpatient function within the NHS, and latterly was known as the Danestrete Centre.

*Detail of the decorative wall treatment on the clinic*. *Photographed in 2022 © K. A. Morrison*

The most distinctive feature of the building is the gymnasium with its decorative quilted finish to the external walls. On the north side the lozenges of aggregate chips are pinned together by blue tiles bearing the coat of arms of Joseph Lister. This alluded to the Lister Hospital, which had been so-named as Lister had attended the Quaker school at Hitchin as a child.

*Detail of the coat of arms on the exterior of the Outpatients’ Centre*. *Photographed in 2022 © K. A. Morrison*

This part of the building was specially designed as an independent reinforced concrete frame structure, to isolate it from the rooms beneath, in order to ‘avoid interference by the activities of this department’.

*The gymnasium in the physiotherapy department of the clinic. From* The Hospital, March 1962, p.151

The remainder of the construction is of brickwork with concrete floors and timber roofs. The ceilings of the corridors and the public spaces, such as the waiting room, were lined with sound absorbent boarding for quietness. Particular efforts were made to provide a ‘homely building’ offering a ‘friendly welcome to the patients’. Accordingly materials and decorations in the waiting areas were carefully chosen to create the desired atmosphere, and a modern touch was provided by a large abstract mural at the entrance, giving a ‘strong and gay splash of colour’.

*Interior view published in 1962, showing the waiting area, with natural wood finishes, patterned lino tiles.* *From* The Hospital, *March 1962.*

The clinic was centrally heated, and apart from its gymnasium, provided a series of consultant and examination rooms, treatment rooms, dental and E.N.T. departments, and small pathological department, x-ray, and pharmacy. The original proposal to include a casualty section was not carried out, and emergency services continued to be dealt with at the old Lister Hospital in Hitchin. The total cost of the building was £95,610.

*Ground Floor Plan of the Outpatients Clinic, from* The Hospital, *March 1962.*

*Upper Floor Plans of the Outpatients Clinic, from* The Hospital, *March 1962*

References: Stevenage Development Corporation, 11th Annual Report, 1 April 1957 to 31 March 1958 and 12th Annual Report, 1 April 1958 to 31 March 1959: Architectural Review, 1 Nov. 1953, p.282: The Hospital, March 1962, pp.147-51.

There is a fuller account of this building in Historic England’s research report on Stevenage Town Centre, which I highly recommend. It can be freely accessed online here https://historic-hospitals.com/2022/04/01/stevenage-outpatients-centre/

Victoria Hospital, Fife

November 3, 2019May 1, 2023 / Harriet Richardson / 2 Comments

*Victoria Hospital, Kirkcaldy, photographed October 2019. Looking north towards the 1960s tower block with the new ward block to the right. © H. Richardson*

Victoria Hospital, Kirkcaldy, and Queen Margaret’s Hospital, Dunfermline, are the two main hospitals in Fife, serving the eastern and western halves of this large county. They both comprise buildings that mark significant periods in the history of post-war hospital architecture, and the Victoria has some of the earliest surviving NHS buildings in Scotland. The site is now dominated by a large, 500-bed ward block built in 2009-12 by Balfour Beatty to designs by Building Design Partnership.

The maternity wing of the new building. Colour and texture, as well as contrasting forms and asymmetry, break up and humanise the large bulk of the most recent development on the site. Photographed in 2019, © H. Richardson

As yet little studied, I have recently been looking into the development of the hospital during the 1950s and 60s, delving into the Department of Health for Scotland files, and the records of the East Fife Hospitals Board of Management. But the story begins long before the National Health Service, and at least one remnant survives of the earliest phase of this hospital.

*One of the original buildings of the Kirkcaldy Burgh fever hospital, dating from 1897 with some later additions and alterations.*

Although not the most architecturally exciting of buildings, at the heart of the modest brick-built building pictured above is an 1890s ward block, part of the original burgh fever hospital. This was built as a scarlet fever ward. There was a larger ward block to its west that was intended for typhoid patients in one half of the building, and diphtheria patients in the other. Between these two was an administration block which also housed some staff accommodation, and there was a laundry and disinfector, mortuary, and gate lodge on the site. Plans for the hospital had been drawn up by the Glasgow architects, Campbell Douglas & Morrison in 1897 to provide accommodation for 33 patients in all.

This map shows the extent of the hospital just prior to the First World War, the surviving ward block is the rectangular building towards the right hand side of the group. Extract from the 2nd edition OS map, revised in 1913, reproduced by permission of the National Library of Scotland.

The fever hospital was extended in 1908, with a sanatorium pavilion for tuberculosis patients (on the site of the present hospice, and possibly partly incorporated in the present building). Further additions were made in 1930 with another sanatorium building and a cubicle isolation block. By the 1940s the hospital had 124 beds, but by then the buildings were not considered up to modern standards. In the run up to the establishment of the National Health Service the plan was to use nearby Cameron Hospital for infectious diseases, and to convert the Victoria into accommodation for the aged and infirm. Cameron Hospital had been considerably extended in the 1930s, its relatively modern buildings and large open site offered the potential to develop a new general hospital there.

*Aerial photograph of Cameron Hospital, Windygates, Fife, taken in 1954. © Crown Copyright: HES*

Difficulties over the acquisition of the additional land required adjacent to Cameron Hospital caused considerable delays. This, together with the time consuming bureaucracy of the new health service, followed by drastic cuts in central funding for new building, lead eventually to the abandonment of the Cameron Hospital scheme in about 1958. In the mean time, a new surgical ward block and other additions had been planned at the Victoria Hospital, with a view to addressing the serious shortage of beds across Fife generally. Work on this extension was nearing completion when the Cameron plan was given up, and the decision taken to build a second, larger block at Kirkcaldy. The 1950s extension therefore became known as phase one, the 1960s development phase two. The contrast in style and planning between these two phases indicates how post-war hospital architecture was developing apace at this time. Both phases are rare survivals of a key moment, demonstrating the evolution of modernist architecture as well as of hospital planning.

Phase I

Preliminary plans for a 100-bed surgical unit at the Victoria site were on the drawing board of the architects’ department of the South East Regional Hospital Board in 1953. By October 1954 they had been broadly approved by the Department of Health and had been submitted to the East Fife Hospitals Board of Management based at Kirkcaldy for their consideration. John Holt, the Regional Board’s chief architect, attended meetings with the local Board of Management to explain the rationale behind the designs.

*View of phases one and two from the south east, photographed in October 2019, © H. Richardson*

The footprint of the ward block adhered to pre-war pavilion planning in its arrangement, if not its internal layout, comprising a three-storey T-plan building divided into three ward wings with the main entrance hall and stair at their meeting point. A single storey range on the north side contained the main out-patients’ department, and another at north-west corner housed a chest clinic. The entire building is flat-roofed, steel framed, and faced in buff-coloured brick and glass curtain walling. The flat roof of the north-east wing had a solarium and roof garden, its reinforced concrete pergola remains a distinctive feature of the building. Roof terraces and solaria were more common in the interwar period, and even then roof gardens were a rare feature in a Scottish hospital.

*View of the north side of Phase I, with the ward tower of Phase II looming behind*

Inside, clinics, offices and the children’s ward were on the ground floor, wards and accommodation for medical staff on the first floor, and further wards and twin operating theatres on the second floor. According to Holt, ward planning was based ‘on the continental practice’ of having wards sited on one side of a central corridor and ancillary rooms on the other. This was known as the Rigs model (referring to the Rigs Hospital, Copenhagen), and was also the basis of the Nuffield Provincial Hospitals Trust’s widely publicised experimental ward built at Greenock in the early 50s.

Detail of the north-east wing, north elevation, the upper two floors treated with glass curtain walling comprising strips of windows over opaque blue glass panels, the cross walls creating a vertical accent carrying up from the pilotis. A tangle of ventilators and air-conditioning units are an inevitable modern addition, muddying the clean lines of the wing. Originally air-conditioning was only provided in the operating theatres. Photographed October 2019, © H. Richardson

Unusually, the operating theatres faced south. This met with surprise from the Board of Management committee, as it was traditional for theatres to be on the north side to benefit from even northern light. Holt explained that the trend was now against providing large theatre windows, rendering their position unimportant, and the theatres here would be air-conditioned, combatting heat from direct sunlight and providing effective bacteriological control.

When work on the surgical block was nearing completion in 1959, it was discovered that the ward doorways were too narrow to allow beds to be wheeled through easily. The standard hospital bed, without mattress, sheets and blankets, was 36 inches wide, and the new ward doorways were fractionally under 40 inches wide. Various suggestions were made for easing the beds through the doorways, but widening them was dismissed as too costly. Metal strips were proposed to be added to the door frames to protect the woodwork, narrower beds were rejected, but narrower mattresses would be used. The matter was also to be ‘kept in mind’ when plans were drawn up for the phase two ward block.

Nurses’ Home, Hayfield House

*Hayfield House, the nurses’ home, north and west elevations, photographed in October 2019, © H. Richardson.*

The nurses’ home, now Hayfield House, has some more overtly modernist features: its upper floors resting on slender pilotis, originally with an open space in the centre. It was constructed in a novel way, using a method that until that time was only used on tall silos. The concrete frame of the building was constructed from shuttered concrete made using continuously sliding forms operated by hydraulic jacks. The timber forms were constructed in situ on the first floor, and given a slight batter to ensure that they were self-clearing. Work was carried out continuously for four days, with 54 men on the day shift and 51 on the night shift. This experimental construction method was recommended by the consultant engineers, Blyth and Blyth, because of the ground conditions. The presence of historic mine workings favoured a concrete frame, being lighter than steel, particularly for a building of this height. Nevertheless, the modernist aesthetic was tempered by the warm tones of the brick facing, pale blue tiles and random-rubble stonework at the entrance.

*Entrance to Hayfield House, with section of rubble-stone wall facing to the right. Photographed in October 2019, © H. Richardson*

Phase II

In 1958 the Department of Health approved a second extension at the Victoria Hospital. Trial borings had to be made on the site once more, to check for underground mine workings, but as soon as the site was deemed suitable detailed planning was begun in the hopes that building work might start in 1961. The architect in charge of phase two was Eric Dalgleish Davidson, who had taken over from Walter Scott on phase one when Scott had left to set up in private practice late in 1957.

A model of phase two was made in 1962, and plans had been finalised by November that year. The annual report of the Scottish Home and Health Department recorded that the second extension to the Victoria was in progress at the end of the year. Officially opened in 1967, phase two is in marked contrast to phase one in style and scale: high rise rather than low rise, uncompromisingly modernist, and adopting a deeper, double-corridor ward plan.

*Architect’s model of Phase II, reproduced from the* Architectural Review, *June 1965* *where it was used in an advertisement for Stramax radiant heating and acoustic tiles.*

An eleven-storey tower sits atop a two-storey podium – in the matchbox-on-a-muffin manner, demonstrated clearly in the model pictured above. The extension housed twice the number of beds as phase one (240), three operating theatres, a new out-patients’ department, A&E, X-ray, sterile supply, physiotherapy and occupational therapy departments, as well as a conference hall, and libraries for patients and medical staff. Eight ward units, each with 30 beds, were located in the tower; the beds were mostly in four-bedded bays, supplemented by single rooms. Various labour-saving devices were introduced making the most of technical innovations.

*View of Phase II from the west. The section with the pitch-roof is the lecture theatre. Photographed in October 2019, © H. Richardson*

In addition to the main ward tower, some of the phase one buildings were extended to meet the demands of the large increase in patients and staff. The kitchen and dining-room building was one that had to be enlarged, but the Board of Management’s hopes for greatly expanded staff recreation facilities (including a swimming pool) proved too expensive.

This view shows a part of the staff kitchen and dining room block on the left – which overlooked the Den burn valley. The Nurses’ Home is behind in the middle distance. The stair tower on the left of the home was added following the tragic and fatal fire which broke out in the home in 1981. Photographed October 2019, © H. Richardson

With the shift from Cameron Hospital to the Victoria as the new general hospital for East Fife, the central laboratory which had been established at Cameron was now in the wrong place. A new laboratory was therefore included in the phase two scheme. Different in style again from either phase one or the ward tower, this distinctly industrial-looking building occupies the north-east corner of the site. The laboratory is square in plan, arranged around an internal courtyard.

*Victoria Hospital, Central Laboratory. Part of the Phase II extension 1962-7. Photographed in October 2019, © H. Richardson*

The phase two extension of the Victoria Hospital is particularly significant in Scottish hospital history because of the involvement of Eric Davidson in its design. Whilst it is difficult to ascribe a single designer to the phase two buildings, Davidson was the architect in charge. In 1960 he had been made Assistant Regional Architect to the South Eastern Regional Hospital Board and also Chairman of the Scottish Hospitals Study Group (1960-4). Following the re-organisation of the NHS in 1974 he became Assistant Director and Chief Architect of the Scottish Health Service Building Division (from 1974 until he retired in 1989). John Holt, likewise, is a key figure in the earlier decades of Scottish hospital design. As the chief architect to the Regional Board, he headed up a department that designed many remarkable buildings extending from hospitals in the Borders, across the Lothians and into Fife.

*The ward tower of the Victoria Hospital, photographed in 2011, with work underway on the new wing to the right.* © *Copyright John Taylor and licensed for reuse under creativecommons.org/licenses/by-sa/2.0*

In the more recent additions to the Victoria Hospital, major architects or architectural firms are also present, with Building Design Partnership for the newest development (completed 2012) and Zaha Hadid for the Maggie’s Centre (2006). Each phase, from the 1890s onwards, encapsulates in built form the ideas, hopes and aspirations of the different times in which they were designed.

*Victoria Hospital new wing, photographed in 2016. © Copyright John Taylor and licensed for reuse under this Creative Commons Licence*

The view above looks south across the double-curved front of the new wing, with its paired entrances sheltered by distinctive, up-turned, curved canopies. The nearer entrance leads to the out-patients’ department and main wards, the farther entrance to the maternity wing. Just visible on the right is the corner of the diminutive Maggie’s Centre.

*Zaha Hadid’s Maggie’s Centre, with the tower of phase II behind to the right. Photographed in October 2019, © H. Richardson*

Sources

National Records of Scotland, Department of Health files: Fife Archives, East Fife Hospitals Board of Management, Minutes; Plans, DG/K/5/121: Department of Health for Scotland, Scottish Hospitals Survey, Report on the South-Eastern Region, 1946: PP, Scottish Home and Health Department, Annual Report for 1967, p.76: The Hospital, Jan. 1960 p.67; December 1960, pp 995-1004; Jan. 1961, p.54; July 1961, p.474; May 1962, pp 303-4; March 1964, p.163; Sept 1967, p.353: AJ, 22 Nov 1956, pp 746-7: Urban Realm, 24 Aug 2012.

The Hospitals on Islay

June 2, 2019May 1, 2023 / Harriet Richardson / 5 Comments

*Islay Hospital, Bowmore. View of the ward block and main entrance from the west. Photographed in May 2019, © H. Richardson*

There have been three hospitals on Islay: a poor law institution that provided medical care for paupers and in the early decades of the National Health Service became the island’s general hospital; an infectious diseases hospital, established in the 1890s, and provided with a permanent small building in 1904; and the present Islay Hospital built in 1963-6, pictured above.

Screen Shot 2016-03-03 at 21.23.29 — *Extract from the 1st-edition OS map, surveyed in 1878, reproduced by permission of the National Library of Scotland*

The earliest of these was the poorhouse, built in 1864-5 on the outskirts of Bowmore on land owned by Charles Morrison. The local Parochial Board decided to get their plans from an Edinburgh architect with experience in such buildings, J. C. Walker. As can been seen from the map above, the building comprised an H-shaped complex. The main north wing was of two storeys, the rest single-storey. (For a photograph of the poorhouse see the Islay History blogspot)

*Gartnatra Hospital, from an old photograph on display at the Columba Centre.*

To comply with the Public Health Acts the local authority had to provide accommodation for cases of infectious disease and so a fever hospital was established at Gartnatra, to the east of Bowmore. Although the building pictured above was built in 1904, there had been a hospital hereabouts since at least the mid-1890s. The local Medical Officer for Health, Dr Ross, reported on an outbreak of measles in 1895, the patient being removed to the hospital. However, as there was no nurse employed by the local authority to attend the hospital, the patient’s mother went to nurse her daughter. Dr Ross had no authority to confine the mother to the hospital, and she went in to the village on many occasions. In a short time the disease spread rapidly throughout Bowmore.

*The former fever hospital, now the Columba Centre. Photographed in May 2019, © H. Richardson*

The situation was finally remedied with the erection of a new building for which the plans were approved by the Local Government Board for Scotland in 1902. To cover the cost of construction a loan of £1,100 was secured from the Public Works Loan Board. The building is dated 1904, and the Local Government Board sanctioned it for occupation in February 1905. It was built by James MacFayden. The building survives, though the interior has been completely refurbished and a large extension built to the rear. It is now in use as a cultural centre. In the photograph below, the old hospital is the gabled block on the left, with the short bay attached (the former sanitary annexe). The rest has been added to form the new cultural centre and cafe.

*The former Gartnatra Hospital, viewed from the east. Photographed in May 2019, © H. Richardson*

With the establishment of the National Health Service in 1948 the administration of Gartnatra Hospital and the poorhouse, latterly known as Gortanvogie House, passed to the Campbeltown and District Hospitals Board of Management, under the Western Regional Hospital Board (WRHB). Under the terms of the National Health Service Act responsibility for the elderly remained with local authorities, so the presence of elderly as well as the sick at Gortanvogie posed problems. In the opinion of the Board of Management, although Gortanvogie left much to be desired, the conditions were probably better than most of the patients enjoyed at home.

Photograph taken in 1955 outside Gortanvogie Hospital. The Matron, Miss C. E. M. Morrison, is seated on the left, and behind her in uniform is the hospital sister, Agnes Watson Miligan. A colleague is pictured seated to the right, and a young patient standing behind. (Reproduced by kind permission of L. Tudball. © L. Tudball.)

Given the list of improvements that the Matron had requested, this makes for a depressing view of those conditions. She had asked, without success, for: electric light – the Hydro Electric Board’s supply reached the front door, but the building was not wired; hot water on the ground floor; a bathroom directly off each main ward on the ground floor; a linen cupboard; wooden or other suitable flooring instead of stone floors; a brick side screen with steel windows along the outside of a covered way between the front and back of the building to stop the inmates from passing through the staff dining-room; essential repairs to the structure of walls and ceilings, and re-slating a large part of the roof. Neglect of building maintenance during the war, common throughout Britain, had left many of the inner walls damp and rotten, with plaster having fallen from many of the ceilings.

*Extract from the 2nd-edition OS map, surveyed in 1897, reproduced by permission of the National Library of Scotland*

Gartnatra, on the other hand, was described as well-built with no serious trace of damp except in two W.C.s at the back on either side which were below a flat part of the roof where the rain water had forced a way in during stormy weather.

‘The site of Gartnatra is bleak and exposed to the prevailing westerly wind coming off the bay; there is nothing “cosy” about the building, but Matron remarked that the islanders are used to hearing the wind roar about their houses. Our visit was on a day of cold rain. A shelter belt of trees would obviously be desirable, but we were told that owing to the wind and the salt spray from the sea, there would be little chance of trees growing.’

*The former Gartnatra hospital, now the Columba Centre, viewed from the south-east. Photographed in May 2019, © H. Richardson*

When the question of modernising the hospital facilities was under discussion, a small team from the mainland visited Islay in May 1952 that included Mr Guthrie, the Regional Hospital Board Architect, Dr Guy, the Medical Officer of Health, and representatives of Argyllshire County Council. The Secretary of the Board of Management for Campbeltown & District Hospitals favoured an extension to Gartnatra but the local doctors argued for a new hospital on a more convenient and sheltered site. Funding was the main problem, but the Department of Health were conscious that spending money on upgrading inferior accommodation was not the best long-term policy.

Plans for extending Gartnatra were drawn up by the WRHB architects, only to be rejected by the Board of Management. With patient numbers dwindling to none, Gartnatra closed in April 1955. The following year the tide had turned towards using Gortanvogie as the hospital and turning Gartnatra over to the local authority as a home for the elderly, and in 1958 sketch plans were drawn up by the WRHB for a new hospital building on the Gortanvogie site. By May 1959 these plans seem to have evolved into something like their final form, encompassing the demolition of Gortanvogie and building in its place two separate buildings, a hospital and a home for the elderly. This was certainly the case by the following May, when some of the problems of shared staff and services were beginning to be discussed.

Islay Hospital, south-west corner of the main block, showing what was originally planned as the patients’ dining and sitting-room and on the left the end of the link corridor to the Eventide Home. © H. Richardson

By July 1960 detailed plans had been drawn up by the WRHB and submitted to the Department of Health. Forbes Murison, Chief Architect to the WHRB, had been building up a central staff of architects with some success, and did not want to have them sitting around doing nothing. The Islay job was one on which he was keen to let them cut their teeth. In 1960 Douglas Gordon McKellar Adam had joined as Principal Assistant, (he became Assistant Chief Architect in 1962).

*Islay Hospital, general view from the entrance looking along the south side of the ward block, photographed in May 2019 © H. Richardson*

In the hopes of gaining the necessary approbation from the Department of Health, the WRHB stressed that Gortanvogie was one of the few examples of an old poorhouse still used in the hospital service in the Western Region. It not only had 12 beds for the sick, but 8 for the old and infirm under the charge of the local authority. Despite the nature of its original purpose, the hospital had in recent times been fulfilling the functions of a cottage hospital by the admission of general and maternity patients. The fabric of the building was so poor as to make reconstruction unviable. Many of the floors were laid directly on the ground, and there was practically no sub-floor ventilation. The intention was to provide all the services of a general cottage hospital and make the island as independent of the air services as practicable. Argyll County Council wished to arrange for the provision of a 20-bedded Eventide Home as part of the scheme, and it was agreed that the one architect should design both, and that this should rest with the Regional Board’s architectural staff.

*The entrance front of the Eventide Home, photographed in May 2019, © H. Richardson*

The new hospital was also originally to provide 20 beds (an additional maternity bed was added later), as well as X-ray, casualty and treatment room, mortuary, boiler-house, kitchen etc, accommodation for the matron and six nurses – considered essential given the location on a ‘remote island’. From the start, the hospital was to be linked to the eventide home by a covered way, and the heating, hot water services and kitchen were to be shared. This raised the question of who should fund what. It also required authorisation from the Treasury as sharing facilities was not authorised by the National Health Service Act. Although combining a hospital with a home for the elderly went against government health policy, as well as introducing the complexity regarding shared funding, mixed institutions were thought to have a place in the more remote parts of the Scottish Islands and Highlands.

*Plan of Islay Hospital, based on original dated January 1962, in the National Records of Scotland. © H. Richardson*

At this point the estimated cost was £146,000. At the end of October the Department forwarded their comments on the plans. Within the Department of Health these were circulated to a team of advisers on the different elements of hospital design, function and administration, each of whom submitted comments, criticisms and suggested alterations. The list of criticisms was lengthy, ranging from concern over the position of the maternity unit below the staff residential quarters (as babies’ crying was liable to cause disturbance), to suggesting that the entrance to the visitors’ viewing room into the mortuary should be placed opposite the doctor’s room rather than in the main hall. Some rooms they thought too small, others too large.

*Islay Hospital. This block was designed as the maternity wing with staff accommodation on the upper floor © H. Richardson*

Treasury approval was granted in November 1960, and the following month the Department was able to give the Regional Board approval in principle to enable planning to proceed. In June 1961 the WRHB sent in revised plans, and raised the issue that the scheme would need to be carried out in two phases, the first phase being the provision of the hospital which could be done without demolishing the existing building, and the second phase being the eventide home following demolition. The revised plan for the eventide home had by then already been agreed to by the County Council, but one of the Department of Health’s architects, R. L. Hume (presumably Robert Leggat Hume, 1899-1980), also discussed the plan with the Regional Board, which seems to have resulted in further revisions.

*Islay Hospital, main entrance © H. Richardson*

Some of the criticisms revolved around room allocation, others around safety. The home was designed around a garden court with a pool in the centre – and so there were concerns that the old people might fall in. Hume discussed the plans with Mr Ellis (Kenneth Geoffrey Ellis), one of the Regional Board’s architects who confirmed that the points raised had been attended to, and that the pool was intended to be shallow with low shrubs or flowers planted around it to keep old people away from the edge. (The plans submitted to the Department were drawn by Ellis, and are dated January 1962.)

Islay Hospital, viewed from the south-east looking towards the maternity and staff quarters’ block. On the left is the rear of the entrance block, and the link range contained treatment rooms and the X-ray room. © H. Richardson

Although it had been hoped that building would start in the financial year 1961-2, the already complex bureaucracy was exacerbated by the apportionment of costs between the Department and the County Council. It was not until June 1962 that the Department sanctioned the preparation of final plans.

*Islay Hospital, from the north-east with the ward block in the centre and the eventide home to the right of the picture © H. Richardson*

Revised plans were submitted in April 1963, and circulated yet again to the Department’s professional advisers for comment. As comments trickled in they were relayed back to the Regional Board, but the Department was at pains to stress that they would not expect drastic alterations to the proposed layout at this stage. The main delaying factors were not difficult to identify: the amount of scrutiny that the project was given had led to ‘a good deal of adverse comment on the plans’; the architectural staff of the WRHB were under pressure to cope with the wider building programme; and the awareness of the shortage of capital funds had generated a reluctance to embark on a relatively expensive project for its size. Once the plans were agreed and the costing completed, work began towards the end of 1963.

*Islay Hospital, north side, with wards and kitchen block. © H. Richardson*

Caution over the estimates was well founded. Within the three years since the original probable costing of around £100,000, it had more than doubled to £236,816. The revised figure took into account the special prices that might be expected to be charged for building on Islay. But everyone involved was aware that costs might still creep up. The main difficulty was attracting a sufficient number of contractors even ‘reasonably interested’ in building on Islay, in order to avoided inflated prices.

*The north-east corner of the Eventide Home, with the link corridor between it and the hospital, photographed in May 2019 © H. Richardson*

The hospital was built first, then Gortanvogie House demolished and the home built on its site. In 1966 work on the hospital was completed. It had cost about £180,000, and provided 12 chronic sick beds, 6 beds for general medicine and 3 maternity beds.

Sources:

National Records of Scotland, HH101/1491: Dictionary of Scottish Architects

Historic Hospitals

An Architectural Gazetteer

NHS History

Dumfries and Galloway Royal Infirmary

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